Psychosocial Dysfunctions, Mood and Anxiety Disorders, Personality Disorders, and Coping Mechanisms

Flashcards covering diagnostic criteria, symptoms, etiology, treatment modalities, stress management techniques, defense mechanisms, and classification systems for psychosocial dysfunctions, mood disorders, anxiety disorders, and personality disorders.

How does the lecture distinguish between a symptom, a dysfunction, and a diagnosis?

A symptom is the pathological manifestation of impairment (e.g., hallucinations, delusions); a dysfunction is disability at the person level (e.g., cannot take care of children, cannot work); and a diagnosis is the formal classification of the illness (e.g., schizophrenia, Anorexia Nervosa).

What is the clinical definition of psychosis?

The inability to distinguish reality from fantasy.

How is concrete thinking defined?

Thought processes focused on immediate experiences and specific objects or events.

What is the distinction between an obsession and a compulsion?

An obsession is the pathological persistence of an irresistible thought that cannot be eliminated by logic, whereas a compulsion is a repetitive behavior carried out in response to an obsession.

What is clanging?

The association of words that are similar in sound but not in meaning.

What speech disturbance is defined as rapid speech that is difficult to interrupt?

Pressure of speech.

How do expressive aphasia and receptive aphasia differ?

In expressive aphasia (motor), language understanding remains intact but the ability to speak is impaired. In receptive aphasia (sensory), the person is unable to comprehend the meaning of words, speaking spontaneously but incoherently.

What is a neologism?

Inventing words that may closely resemble an existing word or may be known only to the individual.

How does the lecture classify memory into four specific timeframes?

Immediate (seconds to minutes), Recent (a few days), Recent past (a few months), and Remote (distant past).

What is akathisia?

Muscular tension occurring as a reaction to medication, particularly antipsychotics.

What is the Global Assessment of Functioning (GAF) scale and what is its numeric range?

A numeric scale from $0$ through $100$ used by mental health clinicians and physicians to subjectively rate an adult's social, occupational, and psychological functioning.

What functional status and symptom level is represented by a GAF score of $91\text{--}100$?

Superior functioning in a wide range of activities, life's problems never seem to get out of hand, sought out by others because of many positive qualities, and no symptoms.

What level of impairment characterizes a GAF score range of $41\text{--}50$?

Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) or any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job).

What are the five axes of the DSM-IV multiaxial classification system?

Axis I: Clinical Disorders and other conditions; Axis II: Personality Disorders and Mental Retardation; Axis III: General Medical Conditions; Axis IV: Psychosocial and Environmental Problems; Axis V: Global Assessment of Functioning.

What are the core symptom criteria and minimum duration required for a Major Depressive Episode?

At least five symptoms present during the same $2\text{-week}$ period representing a change from previous functioning, where at least one symptom must be either depressed mood or loss of interest or pleasure.

What is the minimum duration required to meet the criteria for a Manic Episode versus a Hypomanic Episode?

A Manic Episode requires an elevated, expansive, or irritable mood lasting at least $1\text{ week}$, whereas a Hypomanic Episode requires a distinct period lasting throughout at least $4\text{ days}$.

What defines a Mixed Episode?

The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a $1\text{-week}$ period.

What are the duration and symptom-free limits for diagnosing Dysthymic Disorder?

Depressed mood for most of the day, for more days than not, for at least $2\text{ years}$ ($1\text{ year}$ for children or adolescents), during which the individual has never been without symptoms for more than $2\text{ months}$ at a time.

What dietary restrictions are mandatory when taking Monoamine Oxidase Inhibitors (MAOIs), and why?

Foods high in tyramine (such as aged cheeses, aged meats, soy sauce, fava beans, beer, and wine) must be avoided because consuming them can precipitate a hypertensive crisis.

Why must exercise and perspiration be carefully monitored in patients with Bipolar Disorder taking lithium?

Increases in exercise level with increased perspiration can lead to increased serum lithium levels and lithium toxicity.

What four major goals guide outpatient treatment for Bipolar Disorder?

(1) Identify and manage areas of stress; (2) monitor and support medication adherence while addressing patient ambivalence; (3) develop and maintain the therapeutic alliance; (4) educate both the patient and family about the illness, relapse triggers, and substance abuse risks.

What are the criteria for the onset and peak of a Panic Attack?

A discrete period of intense fear or discomfort in which four or more symptoms develop abruptly and reach a peak within $10\text{ minutes}$.

What criterion must follow recurrent panic attacks for at least $1\text{ month}$ to diagnose Panic Disorder?

Persistent concern about having additional attacks, worry about the implications or consequences of the attack (such as losing control or having a heart attack), or a significant change in behavior related to the attacks.

What is the minimum duration of fear required when diagnosing a Specific Phobia in individuals under $18\text{ years}$ of age?

At least $6\text{ months}$.

What time threshold makes obsessions or compulsions clinically diagnostic in OCD?

They cause marked distress, are time-consuming by taking more than $1\text{ hour}$ a day, or significantly interfere with the person's normal routine, occupational functioning, or social relationships.

How do PTSD and Acute Stress Disorder differ regarding their duration and timeline of onset?

Acute Stress Disorder lasts for a minimum of $2\text{ days}$ and a maximum of $4\text{ weeks}$ and occurs within $4\text{ weeks}$ of the traumatic event; PTSD requires a symptom duration of more than $1\text{ month}$.

What are the core duration and symptom criteria for Generalized Anxiety Disorder (GAD)?

Excessive anxiety and worry occurring more days than not for at least $6\text{ months}$ about a number of events or activities, associated with at least three of six specified symptoms (such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension, or sleep disturbance).

How does Systematic Desensitization differ from Exposure and Response Prevention (ERP)?

Systematic Desensitization uses incremental exposure alongside relaxation and imagery to diminish anxiety until real contact is achieved, whereas ERP specifically exposes the patient while preventing behavioral responses to obsessional thoughts.

In which four areas of functioning must an enduring pattern be manifested to meet general criteria for a Personality Disorder?

(1) Cognition (perception of self and others); (2) Affectivity (emotional response); (3) Interpersonal functioning; (4) Impulse control.

Which conditions belong to Cluster A personality disorders, and what is their general presentation?

Paranoid Personality Disorder, Schizoid Personality Disorder, and Schizotypal Personality Disorder; they generally appear odd, eccentric, or socially detached.

What age criteria and developmental history are required to diagnose Antisocial Personality Disorder?

The individual must be at least $18\text{ years}$ of age, have a history of disregard for the rights of others occurring since age $15$, and have evidence of Conduct Disorder with onset before age $15$.

What interpersonal pattern is characteristic of Borderline Personality Disorder?

A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

Which personality disorders are linked to fixation at the oral, anal, and phallic stages of psychosexual development according to the lecture?

Oral fixation is linked to Dependent Personality Disorder, anal fixation to Obsessive-Compulsive Disorder, and phallic fixation to Histrionic Personality Disorder.

Who developed Dialectical Behavior Therapy (DBT), and what are its primary clinical goals in Borderline Personality Disorder?

Developed by Marsha Linehan, PhD; it is a skills-based therapy focused on developing coping skills to improve affective stability and impulse control, and reducing self-harmful behavior.

What physiological mechanism explains the therapeutic effects of Autogenic Training?

It restores balance between the sympathetic (fight-or-flight) and parasympathetic (rest-and-digest) branches of the autonomic nervous system, thereby promoting digestion, lowering blood pressure, slowing heart rate, and supporting immune function.

Who developed Progressive Muscle Relaxation (PMR), and what is its core premise?

Developed by American physician Edmund Jacobson in the early 1920s; the premise is that because muscular tension accompanies anxiety, one can reduce anxiety by learning to voluntarily relax muscular tension.

What are the recommended time spans for tensing and relaxing during Progressive Muscle Relaxation?

Each tensing period lasts for $10\text{ seconds}$, and each relaxing period lasts for $10\text{ to }15\text{ seconds}$.

What is the typical physical dimension of a stress ball as stated in the lecture?

A malleable toy, usually not more than $7\text{ cm}$ in diameter.

How does George Vaillant (1993) categorize defense mechanisms?

Along a continuum from psychotic to mature, evaluated based on their utility in promoting mature, adult functioning.

How is the defense mechanism of Reaction Formation defined?

A neurotic defense whereby conscious thoughts and feelings are the polar opposite of unfelt, unconscious thoughts and wishes.

What defines the mature defense mechanism of Sublimation?

Unacceptable feelings and impulses are not camouflaged or denied but instead are channeled into a socially acceptable, constructive outlet (e.g., sports or the arts).

How does the mature defense of suppression differ from repression?

Suppression is a conscious or semi-conscious decision to postpone paying attention to a thought or wish, whereas repression is an unconscious process by which the ego pushes painful thoughts out of awareness entirely.